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Frequently Asked Questions Insurance

Divorce

  • Yes.  Spouses of federal annuitants are covered under a family enrollment in the Federal Employees Health Benefits (FEHB) Program during the divorce process and during a legal separation.  Spouses of annuitants lose eligibility for FEHB coverage when the divorce is final.  Former spouses of annuitants can apply for coverage in the FEHB Program under the Spouse Equity or Temporary Continuation of Coverage provisions of the FEHB law. Former spouses of annuitants must contact the annuitant’s retirement system within 60 days after the divorce to apply.   For more information on divorce after retirement, please visit http://www.opm.gov/insure/health/faq/divorce.asp.
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  • The "Federal Employees Health Benefits Children's Equity Act of 2000" requires mandatory Self and Family enrollment coverage for FEHB-eligible employees who do not comply with a court or administrative order to provide health insurance coverage for their child(ren). You should send a copy of the court order to your ex-spouse's Human Resources Office. They will ensure that your ex-spouse has an FEHB Self and Family enrollment that provides coverage for the children. If your ex-spouse does not have a Self and Family enrollment, his Human Resources Office will enroll him in the Self and Family option of his current FEHB plan. If his current plan is an HMO and the child(ren) don't live within the service area of this plan, they will enroll him in the Basic Option of the Blue Cross and Blue Shield Service Benefit Plan. Please be sure to include your home address in your notification so that the Human Resources Office can make this determination. The Human Resources Office will send you a copy of the SF 2809, Health Benefits Election Form. They will also send a copy to the FEHB plan so the plan can update their records and send ID cards to you. The Human Resources Office will flag your ex-spouse's health insurance records to prevent him from making a change to a Self Only enrollment for as long as the court order requires him to provide health insurance coverage to your child(ren) or until the youngest child reaches age 26, whichever occurs first.
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  • Only you and the children born to or adopted by you and your former spouse (the Federal employee or annuitant) are covered under a Self and Family enrollment. Your child must be under age 26 or be incapable of self-support because of a mental or physical disability that existed before age 26. Your children cannot be covered under more than one FEHB enrollment. If the employee or annuitant covers the children under his/her FEHB enrollment, your Spouse Equity enrollment should be for Self Only coverage.
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  • The time limit for notification is 60 days from your divorce or annulment. Either you or your former spouse must notify the employing office in writing that you want TCC. If your former spouse is retired, notify the retirement system.
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  • No. According to the FEHB law, if you or your former spouse didnt notify the employing office within the 60-day limit, your opportunity to elect TCC ends 60 days after your divorce or annulment.
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  • Spouse Equity:
    1. If you qualify for Spouse Equity, you can elect FEHB coverage in your own right.
    2. Your coverage continues indefinitely, as long as you continue to meet the requirements (see next section) and pay your premiums.
    3. You must pay both the employee and government shares of your plans FEHB premium.
    4. You do not have to pay the extra 2% administrative charge.
    TCC:
    1. Your coverage is limited. It will end 36 months after your divorce or annulment, or earlier if you do not pay your premiums.
    2. You must pay both the employee and government shares of your plans FEHB premium, plus an administrative charge equal to 2% of total plan premiums.
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  • No, the children are entitled to receive benefits under only one enrollment.  Generally, when divorce occurs, one parent will enroll in Self Only coverage and the other parent will enroll in Self and Family coverage to provide benefits for the children.  If there is a reason for both parents to enroll in Self and Family coverage (i.e., both parents have remarried and need Self and Family enrollments to cover their new spouses and stepchildren), each enrollee must notify his or her insurance carrier of the name(s) of the child(ren) to be covered under his/her enrollment to prevent ant child from receiving dual coverage under FEHB (which is prohibited by Federal law).
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  • Only you and the children born to or adopted by you and your former spouse (the Federal employee or annuitant) are covered.
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  • You can keep your Spouse Equity coverage indefinitely if you pay your premiums on time, don't remarry before age 55, and don't lose your entitlement to an annuity or survivor annuity.
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  • TCC is a feature of the FEHB Program that allows certain people to temporarily continue their FEHB coverage after regular coverage ends. Please note that you must exhaust TCC eligibility, as one condition for guaranteed access to individual coverage under the Health Insurance Portability and Accountability Act of 1996.
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